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Diagnostic Imaging (diagnostic + imaging)
Terms modified by Diagnostic Imaging Selected AbstractsWHO Manual of Diagnostic Imaging.JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2005Interpretation of the Musculoskeletal System, Radiographic Anatomy No abstract is available for this article. [source] Follicular lymphoid hyperplasia simulating intussusception in a 6-year-old boy: Clinical, radiological and histopathological findingsJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2003Ludger W Poll Summary We report the case of a 6-year-old boy who initially presented with recurrent abdominal pain. Diagnostic imaging, including ultrasound and CT, showed findings typical of an ileocecal intussusception with abdominal lym-phadenopathy. Sonographically, the morphological appearance of the intussusception did not change during a 4-week follow-up period. Surgery was performed on the tentative diagnosis of a tumour versus lymphoma. Upon laparatomy, intussusception was ruled out and a large, broad-based tumour of the caecum was palpable. The histopathology after ileocecal resection revealed follicular lymphoid hyperplasia. Where there is radiological suspicion of an intussusception in children with no or insignificant symptoms, follicular lymphoid hyperplasia should be included in the differential diagnosis. [source] Diagnostic imaging of hepatocellular carcinoma in patients with cirrhosis before liver transplantationLIVER TRANSPLANTATION, Issue S2 2006Bachir Taouli Key Concepts: 1The lack of whole-liver explant correlation has led to an overestimation of the sensitivity of imaging tests for the diagnosis of HCC in the radiological literature. 2Ultrasound is insensitive for the diagnosis of HCC in the cirrhotic liver and should not be used for the detection of focal liver lesions in this setting. 3Although magnetic resonance (MR) imaging is more sensitive than multidetector 3-phase computed tomography (CT) for the diagnosis of regenerative and dysplastic nodules it is probably no better than CT for detection of HCC and has a lower false-positive rate. 4Approximately 10,30% of nodules measuring <2 cm seen only on the hepatic arterial phase at CT or MR imaging represent small HCC and vigilant surveillance imaging is required as interval growth is the best indicator of malignancy. Liver Transpl 12:S1,S7, 2006. © 2006 AASLD. [source] Technical note: Terahertz imaging of ancient mummies and boneAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2010Lena Öhrström Abstract Ancient mummified soft-tissues are a unique source to study the evolution of disease. Diagnostic imaging of such historic tissues is of foremost interest in paleoanthropology or paleopathology, with conventional x-ray and computed tomography (CT) being the gold-standard. Longer wavelength radiation in the far-infrared or Terahertz region allows diagnostic close-to-surface tissue differentiation of bone morphology while being harmless to human cells. The aim of this study is to show the feasibility and the morpho-diagnostic impact of THz imaging of historic remains. Images of an artificially embalmed ancient Egyptian human mummy hand, an artificially embalmed ancient Egyptian mummified fish and a macerated human lumbar vertebra were obtained by THz-pulse imaging and compared with conventional X-ray and CT images. Although conventional x-ray imaging provides higher spatial resolution, we found that THz-imaging is well-suited for the investigation of ancient mummified soft tissue and embalming-related substances / wrappings. In particular, bone and cartilaginous structures can be well differentiated from surrounding soft-tissues and bandage-wrappings by THz imaging. Furthermore, THz-pulse imaging also measures the time-delay of the pulsed signal when passing through the sample, which provides supplementary information on the optical density of the sample that is not obtained by X-ray and CT. Terahertz radiation provides a completely non-invasive diagnostic imaging modality for historic dry specimens. We anticipate this modality also to be used for detection of hidden objects in historic samples such as funerary amulets still in situ in wrapped mummies, as well as potentially for the identification of spectral signatures from chemical substances, e.g., in embalming essences.. Am J Phys Anthropol, 2010. © 2010 Wiley-Liss, Inc. [source] Adventures in multivalency, the Harry S. Fischer memorial lecture CMR 2005; Evian, FranceCONTRAST MEDIA & MOLECULAR IMAGING, Issue 1 2006Michael F. Tweedle Abstract This review discusses multivalency in the context of drug discovery, specifically the discovery of new diagnostic imaging and related agents. The aim is to draw attention to the powerful role that multivalency plays throughout research involving molecular biology, in general, and much of biochemically targeted contrast agent research, in particular. Two examples from the author's laboratory are described. We created small (,5,kDa) peptide ,dimers' composed of two different, chemically linked peptides. The monomer peptides both bound to the same target protein with Kd,,,100,s,nM, while the heterodimers had sub-nM Kd values. Biological activity was evident in the heterodimers where none or very little existed in homodimers, monomers or monomer mixtures. Two different tyrosine kinases (KDR and C-Met) and four peptide families produced consistent results: multivalent heterodimers were uniquely different. The second example begins with making two micron ultrasound bubbles coated with the peptide, TKPPR (a Tuftsin antagonist) as a negative control for bubbles targeted with angiogenesis target-binding peptides. Unexpected binding of a ,negative' control, (TKPPR)-targeted bubble to endothelial cells expressing angiogenesis targets, led to the surprising result that TKPPR, only when multimerized, binds avidly, specifically and actively to neuropilin-1, a VEGF co-receptor. VEGF is the primary stimulator of angiogenesis. Tuftsin is a small peptide (TKPR) derived from IgG that binds to macrophages during inflammation, and has been studied for over 30 years. The receptor has never been cloned. The results led to new conclusions about Tuftsin, neuropilin-1 and the purpose, up to now unknown, of exon 8 in VEGF. Multivalency can be used rationally to solve practical problems in drug discovery. When targeting larger structures, multivalency is frequently unavoidable, and can lead to unpredictable and useful biochemical information, as well as to new drug candidates. Copyright © 2006 John Wiley & Sons, Ltd. [source] The sarcomatous guise of cervical ectopic hamartomatous thymoma,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2002Jeff Marschall MD Abstract Background Ectopic hamartomatous thymoma is a rare benign neoplasm occurring in the deep soft tissues adjacent to the sternoclavicular joint. Although clinical presentation and diagnostic imaging can be consistent with a malignant lesion such as a sarcoma, recognition of pathologic features can readily exclude such a diagnosis. However, this remains a challenge caused by their unusual histologic features and diverse composition. Recognition of this tumor is, however, important, because it follows a benign clinical course, and conservative surgical excision is the therapy of choice. Methods A literature review of all reports of ectopic hamartomatous thymoma was undertaken and compared with our indexed case. Results From this review, we identified 26 previous reports. Most patients were men, with a 4.5:1 predominance. There was a wide range of ages at presentation, from 26 to 79 years. All tumors were located in the lower neck, with the exception of one arising presternally. Treatment predominantly consisted of tumor resection, with no reported recurrences on follow-up. Conclusions We conclude that ectopic hamartomatous thymoma is an extremely rare neoplasm usually presenting in the lower neck. Correct identification of this tumor is important, because it follows a benign course, and surgical excision is adequate therapy. © 2002 Wiley Periodicals, Inc. Head Neck 24: 800,804, 2002 [source] Prescription practices of diagnostic imaging in dementia: a survey of 47 Alzheimer's Centres in Northern ItalyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2003R. Riello Abstract Background To date, there are no data at the national or European level on the prescription practices of imaging (CT, MR, and SPET) in the diagnosis of cognitively impaired elderly patients. Methods We addressed prescription practices of diagnostic imaging in 47 Alzheimer's Centres in Northern Italy, with an ad-hoc questionnaire. Results The use of imaging in new cases was relatively intensive: 62% of the Alzheimer's Centres prescribed CT to more than 95% of cases, 24% prescribed MR to more than 33% of cases, and 33% prescribed SPET to more than 5% of cases. A minority of Alzheimer's Centres (n,=,3, 6%) prescribed imaging to less than 100% of new cases. The association between onsite scanner availability and frequency of prescription increased from CT (Odds ratio (OR),=,1.8) through MR (OR,=,2.4) to SPET (OR,=,4.6), although only the latter was significant (95% confidence interval (CI) 1.2,17.7, p,=,0.003). Patient-related factors (age, severity of cognitive impairment, and clinical suspicion of cerebrovascular disease) influenced prescription of structural imaging in 30,53% of Alzheimer's Centres and organizational factors (onsite scanner availability, and waiting list) in a similar proportion (32 and 43% respectively). Conclusions Organizational factors play a relevant role in the prescription of imaging exams in patients with cognitive impairment and, at least for CT, the perceived diagnostic added value is rather low, suggesting a high degree of uncertainty in the clinical use of imaging techniques. Copyright © 2003 John Wiley & Sons, Ltd. [source] Immunotherapy against metastatic renal cell carcinoma with mature dendritic cellsINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2007Akihiko Matsumoto Objective: We performed a clinical trial of immunotherapy using autologous mature dendritic cells (DC) pulsed with autologous tumor lysate, for patients with metastatic renal cell carcinoma (RCC). Methods: Patients with refractory metastatic RCC were enrolled in the study. All of them received interferon (IFN)-, treatment after nephrectomy and were followed over 3 months prior to this study. Autologous monocyte-derived immature DC were pulsed with lysate from autologous primary tumor as the antigen and keyhole limpet hemocyanin (KLH) as immunomodulator, and cultured in the presence of tumor necrosis factor (TNF)-,, interleukin (IL)-1,, and prostaglandin (PG)E2 to generate mature DC. Mature DC were injected intradermally near bilateral inguinal lymph nodes of the patients. A delayed-type hypersensitivity (DTH) test and enzyme-linked immunospot (ELISPOT) assay were performed to evaluate the immunological response. After 4 months from first injection, the clinical effect was evaluated by diagnostic imaging. Results: The treatments were well tolerated without significant toxicity by the patients who were an average of 65.7 years old and had multiple metastases in the lung and other organs. One of the two patients developed a positive DTH reaction to tumor lysate and the other patient only to KLH. The patient with a positive DTH reaction to tumor lysate had stable disease in the clinical evaluation. Conclusions: We confirmed the safety of DC therapy in this clinical trial. The DTH test revealed that the DC therapy induced immunological response to RCC. On the other hand, it was necessary to reconsider the patient selection criteria. [source] Usefulness of diagnostic imaging in primary hyperparathyroidismINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2003KAZUYA SEKIYAMA Abstract Background : In patients with primary hyperparathyroidism, prevention of urinary stone recurrence can be achieved by surgical removal of the enlarged parathyroid gland. To ensure the efficacy of surgery for primary hyperparathyroidism, preoperative localization of the enlarged gland is important. In the present study, usefulness of diagnostic imaging for localization of the enlarged gland was investigated in primary hyperparathyroidism. Methods : We retrospectively examined the findings of imaging studies and clinical records in 79 patients (97 glands) who underwent surgical treatment for primary hyperparathyroidism at Chiba University Hospital between 1976 and 2000. The detection rates of accurate localization were investigated for imaging techniques, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), thallium-201 and technetium-99m pertechnetate (Tl-Tc) subtraction scintigraphy and 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy, and analysed in relation to the size and weight of the gland and pathological diagnosis. Results : The detection rates by US, CT, MRI, Tl-Tc subtraction scintigraphy and MIBI scintigraphy were 70%, 67%, 73%, 38% and 78%, respectively. The overall detection rate changed from 50% to 88% before and after 1987. The detection rate of MIBI scintigraphy was superior to Tl-Tc subtraction scintigraphy. Conclusion : In primary hyperparathyroidism, improvement of accurate localization of an enlarged parathyroid gland was demonstrated along with recent advances in imaging techniques including MIBI scintigraphy. [source] Bisphosphonate-Associated Osteonecrosis of the Jaw: Report of a Task Force of the American Society for Bone and Mineral Research,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 10 2007Sundeep Khosla (Chair) Abstract ONJ has been increasingly suspected to be a potential complication of bisphosphonate therapy in recent years. Thus, the ASBMR leadership appointed a multidisciplinary task force to address key questions related to case definition, epidemiology, risk factors, diagnostic imaging, clinical management, and future areas for research related to the disorder. This report summarizes the findings and recommendations of the task force. Introduction: The increasing recognition that use of bisphosphonates may be associated with osteonecrosis of the jaw (ONJ) led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address a number of key questions related to this disorder. Materials and Methods: A multidisciplinary expert group reviewed all pertinent published data on bisphosphonate-associated ONJ. Food and Drug Administration drug adverse event reports were also reviewed. Results and Conclusions: A case definition was developed so that subsequent studies could report on the same condition. The task force defined ONJ as the presence of exposed bone in the maxillofacial region that did not heal within 8 wk after identification by a health care provider. Based on review of both published and unpublished data, the risk of ONJ associated with oral bisphosphonate therapy for osteoporosis seems to be low, estimated between 1 in 10,000 and <1 in 100,000 patient-treatment years. However, the task force recognized that information on incidence of ONJ is rapidly evolving and that the true incidence may be higher. The risk of ONJ in patients with cancer treated with high doses of intravenous bisphosphonates is clearly higher, in the range of 1,10 per 100 patients (depending on duration of therapy). In the future, improved diagnostic imaging modalities, such as optical coherence tomography or MRI combined with contrast agents and the manipulation of image planes, may identify patients at preclinical or early stages of the disease. Management is largely supportive. A research agenda aimed at filling the considerable gaps in knowledge regarding this disorder was also outlined. [source] Bilateral Axillary Artery Perfusion to Reduce Brain Damage during Cardiopulmonary BypassJOURNAL OF CARDIAC SURGERY, Issue 2 2010Kazuhiro Kurisu M.D. The aim of the present study was to examine the value of bilateral axillary artery perfusion during thoracic aortic and cardiac surgery, and to evaluate the clinical results with a particular focus on cerebral damage. Methods: From March 2002 through December 2007, 24 patients (16 male and eight female; age range, 43 to 84 years) underwent bilateral axillary artery perfusion through side grafts during cardiopulmonary bypass. Aortic surgery, including total arch replacement, hemiarch replacement, and ascending aortic replacement, was performed in 21 patients. Bilateral axillary artery perfusion was also used in three complicated valve surgeries after expanding its indication to cardiac pathology with a diseased aorta, two redo cases with severe atherosclerotic vascular disease, and one case with a porcelain aorta. Results: Bilateral axillary artery perfusion was successful in all patients. There were no complications related to this procedure except in one patient, who suffered from a local fluid retention in one wound, requiring puncture drainage. There was no hospital mortality. No strokes were identified by either clinical assessments or diagnostic imaging. Conclusions: Bilateral axillary artery perfusion is a useful method for protection of the brain during either thoracic aortic or cardiac surgery when the patients have an extensively diseased aorta.,(J Card Surg 2010;25:139-142) [source] Prospects for progress in diagnostic imagingJOURNAL OF INTERNAL MEDICINE, Issue 4 2000E. J. Potchen Abstract. Potchen EJ (Michigan State University, Michigan, USA). Prospects for progress in diagnostic imaging (Internal Medicine in the 21st Century). J Intern Med 2000; 247: 411,424. New fast-imaging MRI systems designed specifically for cardiac magnetic resonance enable new applications of noninvasive vascular imaging. The use of functional MRI and diffusion tensor imaging to map brain function and structure offers a new dimension to an understanding of the human condition. Clinical applications of functional MRI will influence many specialties including surgery, education, and rehabilitation. Functional imaging has the potential to visualize the regional concentration of specific proteins. This imaging at the level of molecules may be possible by use of a contrast material whose signal is changed by local enzymatic activity. The three-dimensional digital data collected in modern imaging techniques allow for virtual endoscopy in the respiratory, alimentary, and cardiovascular systems. Virtual endoscopy may replace many of the more invasive diagnostic methods in the near future. The measurement of clinical decision-making through observer performance studies better informs both the physician and the patient on how to improve upon the quality of clinical practice. These prospects for progress reinforce diagnostic imaging as a cornerstone in medical informatics. The history of creating images used in medicine reveals the invention of diagnostic tools which may provide new information but premature use can result in improper application of a poorly understood technology. Research into the use of new technology may be as important as the technology itself in improving the human condition. [source] Magnetic Resonance Imaging in the staging of cervical carcinoma: A pictorial reviewJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2008GEC Smith Summary The purposes of diagnostic imaging in cervical carcinoma are to determine the size and extent of the tumour for accurate staging and to establish lymph node status. Historically, cervical tumours were staged by clinical examination and by examination under anaesthesia according to the International Federation of Gynecology and Obstetrics staging system. This system does not incorporate imaging findings or lymph node status, but it is now accepted that cross-sectional imaging, and in particular MRI, has an important role to play in the staging of these tumours. We carried out an audit of all patients having a staging MRI for suspected cervical carcinoma in South Australia and the Northern Territory for 2 years from January 2005. This was the first time the clinicians had been offered routine MRI, and despite the strong supporting published reports, they had some reservations about its performance. Our audit covered a wide range of tumour stages and provided a good teaching resource for radiologists and clinicians alike. [source] Magnetic Resonance Imaging of the Hypothalamic-Neurohypophyseal SystemJOURNAL OF NEUROENDOCRINOLOGY, Issue 4 2004I. Fujisawa Abstract Magnetic resonance imaging (MRI) is a revolutionary advance in diagnostic imaging of the hypothalamic-neurohypophyseal system (HNS). The detailed anatomy of the sellar and parasellar region is clearly visible using MRI, because it has no bony artifacts and multidirectional capability. The posterior lobe of the pituitary gland displays a characteristic bright signal on the MR T1-weighted image (T1WI), and is distinctly separated from the anterior lobe. The bright signal is absent in patients with central diabetes insipidus, and is thought to reflect normal vasopressin storage in the posterior lobe. The signal intensity ratio of the posterior lobe to the pons on T1WI is strongly correlated with vasopressin content in the posterior lobe. In addition to the morphological evaluation, MRI provides unique information concerning the function of the HNS. The MRI findings of the HNS (normal condition, central diabetes insipidus, a depleted posterior lobe, an ectopic posterior lobe, and a damming-up phenomenon of the neurosecretory vesicles in the pituitary stalk) are demonstrated in this article. [source] Radiation exposure and diagnostic imagingJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2010CRNP (Assistant Professor), Luann Richardson PhD Purpose: The purpose of this article is to increase clinician awareness of current radiation exposures of diagnostic testing, discuss current practice patterns, and suggest strategies to address issues at the systems level, institution level, and the healthcare provider level. Data sources: Evidence-based literature including interdisciplinary peer-reviewed articles in the biological and health-related fields. Conclusions: Radiation exposure related to diagnostic testing is often higher than anticipated for both the clinician and the patient. Strategies to address radiation exposure need to be implemented at many different levels in the system. Best practice initiatives are surfacing and will require a team approach for success. Implications for practice: Nurse practitioners need to be aware of the benefits and risks of diagnostic testing involving radiation exposure. Patients should also be informed of potential risks and benefits. Alternative imaging should be considered and repetitive testing should be monitored closely. [source] Clinical probability and alveolar dead space measurement for suspected pulmonary embolism in patients with an abnormal D-dimer test resultJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 7 2006O. SANCHEZ Summary.,Background: Most patients with suspected pulmonary embolism (PE) have a positive D-dimer test and undergo diagnostic imaging. Additional non-invasive bedside tests are required to reduce the need for further diagnostic tests. Objectives: We aimed to determine whether a combination of clinical probability assessment and alveolar dead space fraction measurement can confirm or exclude PE in patients with an abnormal D-dimer test. Methods: We assessed clinical probability of PE and alveolar dead space fraction in 270 consecutive in- and outpatients with suspected PE and positive D-dimer. An alveolar dead space fraction < 0.15 was considered normal. PE was subsequently excluded or confirmed by venous compression ultrasonography, spiral computed tomography and a 3-month follow-up. Radiologists were unaware of the results of clinical probability and capnography. Results: PE was confirmed in 108 patients (40%). Capnography had a sensitivity of 68.5% (95% confidence interval [CI]: 58.9,77.1%) and a specificity of 81.5% (95% CI: 74.6,87.1%) for PE. Forty-five patients (16.6%) had both a low clinical probability and normal capnography (sensitivity: 99.1%, 95% CI: 94.9,100%) and 34 patients (12.6%) had both a high clinical probability and abnormal capnography (specificity: 100%, 95% CI: 97.7,100%). Conclusion: Capnography alone does not exclude PE accurately. The combination of clinical probability and capnography accurately excludes or confirms PE and avoids further testing in up to 30% of patients. [source] Acute pancreatitis in dogsJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 4 2003Jennifer L. Holm DVM Abstract Objective: To summarize current information regarding severity assessment, diagnostic imaging, and treatment of human and canine acute pancreatitis (AP). Human-based studies: In humans, scoring systems, advanced imaging methods, and serum markers are used to assess the severity of disease, which allows for optimization of patient management. The extent of pancreatic necrosis and the presence of infected pancreatic necrosis are the most important factors determining the development of multiple organ failure (MOF) and subsequent mortality. Considerable research efforts have focused on the development of inexpensive, easy, and reliable laboratory markers to assess disease severity as early as possible in the course of the disease. The use of prophylactic antibiotics, enteral nutrition, and surgery have been shown to be beneficial in certain patient populations. Veterinary-based studies: The majority of what is currently known about naturally occurring canine AP has been derived from retrospective evaluations. The identification and development of inexpensive and reliable detection kits of key laboratory markers in dogs with AP could dramatically improve our ability to prognosticate and identify patient populations likely to benefit from treatment interventions. Treatment remains largely supportive and future studies evaluating the efficacy of surgery, nutritional support and other treatment modalities are warranted. Data sources: Current human and veterinary literature. Conclusions: Pancreatitis can lead to a life-threatening severe systemic inflammatory condition, resulting in MOF and death in both humans and dogs. Given the similarities in the pathophysiology of AP in both humans and dogs, novel concepts used to assess severity and treat people with AP may be applicable to dogs. [source] Neurologic Dysfunction in Hypothyroid, Hyperlipidemic Labrador RetrieversJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2007Christina L. Vitale Background: Hypothyroidism has been associated with a variety of neurologic signs, but the mechanism for this association is not completely understood. Hypothyroidism also is associated with hyperlipidemia that predisposes to atherosclerosis, increased blood viscosity, and thromboembolic events. Objective: The objective is to characterize neurologic signs potentially associated with hyperlipidemia and atherosclerosis in canine hypothyroidism. Animals: This study used dogs referred to North Carolina State University Veterinary Teaching Hospital for evaluation of neurologic signs. Materials and Methods: A retrospective study was conducted in which medical records of dogs with neurologic signs and a diagnosis of hypothyroidism and hyperlipidemia were reviewed. Details of the history, presenting signs, results of routine blood tests, thyroid tests, cerebrospinal fluid (CSF) analysis and diagnostic imaging, and response to therapy were compiled. Results: Three Labrador Retrievers and one Labrador Retriever cross fit the inclusion criteria. All dogs were hypothyroid and severely hyperlipidemic. Neurologic signs included tetraparesis, central and peripheral vestibular signs, facial paralysis, and paraparesis. Two dogs had an acute history and rapid resolution of signs consistent with an infarct, the presence of which was confirmed in 1 of the dogs by magnetic resonance imaging. Two dogs had chronic histories of cranial neuropathies and paraparesis. One of these dogs had evidence of iliac thrombosis and atherosclerosis on ultrasound examination. All dogs improved with thyroid hormone supplementation. Clinical Relevance: Labrador Retrievers may be predisposed to the development of severe hyperlipidemia in association with hypothyroidism. One possible consequence of severe hyperlipidemia is the development of neurologic signs due to atherosclerosis and thromboembolic events. [source] Meningioangiomatosis in Young Dogs: A Case Series and Literature ReviewJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2004Todd M. Bishop Meningioangiomatosis (MA) is a proliferative disorder of the central nervous system (CNS) that has been reported rarely in humans and sporadically in dogs. Meningioangiomatosis may occur in the brainstem or cervical spinal cord of young dogs and can be identified tentatively by magnetic resonance imaging. The histopathologic hallmark of MA is a leptomeningeal plaque that extends along the CNS microvasculature and invades the adjacent neural parenchyma. This case series describes the neurologic signs, clinical progression, diagnostic imaging, and neuropathology of 4 dogs with MA. The 4 dogs with MA are compared and contrasted with 4 previously reported cases in dogs as well as with their human counterpart. [source] Optical clearing of in vivo human skin: Implications for light-based diagnostic imaging and therapeuticsLASERS IN SURGERY AND MEDICINE, Issue 2 2004Misbah H. Khan MD No abstract is available for this article. [source] Liver tumors: Pediatric population,LIVER TRANSPLANTATION, Issue 11 2008Milton J. Finegold Liver tumors in childhood are rare and are typically not detected clinically until they reach a large size and often spread within the organ or metastasize. This can make surgical resection problematic, and almost all of them require extirpation for cure. With very effective chemotherapy for hepatoblastoma and to some extent for sarcomas, many cancers can be shrunk to permit partial hepatectomy, but for most hepatocarcinomas, some of the other malignancies, and even some benign proliferations, their location at the hilum and multiplicity of masses in multiple lobes make transplantation the treatment of choice. Major advances in diagnostic imaging, especially enhanced computed tomography and magnetic resonance imaging, permit a preoperative choice of resection versus transplantation to be achieved in almost all instances, and for the remainder, intraoperative ultrasonography can further help to determine the most desirable approach. The outcome is very much better in the case of hepatoblastoma when transplantation is a primary modality rather than following unsuccessful attempts at resection. In this review, transplantation for liver tumors in children is considered from all aspects, including the importance of screening for tumors whenever possible to avoid the need for transplantation. Liver Transpl 14:1545,1556, 2008. © 2008 AASLD. [source] Use of yttrium-90 microspheres (TheraSphere®) in a patient with unresectable hepatocellular carcinoma leading to liver transplantation: A case reportLIVER TRANSPLANTATION, Issue 9 2005Laura M. Kulik Prior to therapy, model for end stage liver disease (MELD) scoring, diagnostic imaging and tumor staging were performed in a patient with T3 HCC. The patient received an orthotopic liver transplant (OLT) 42 days after treatment. The explant specimen showed complete necrosis of the target tumor. Follow-up of this patient has demonstrated no evidence of recurrence. There was no life threatening or fatal adverse experiences related to treatment. This case report documents the natural course, history and outcome of a patient treated with yttrium-90 for unresectable HCC. The patient was downstaged from T3 to T2 and was subsequently transplanted. (Liver Transpl 2005;11:1127,1131.) [source] Peptide-based radiopharmaceuticals: Future tools for diagnostic imaging of cancers and other diseasesMEDICINAL RESEARCH REVIEWS, Issue 3 2004S.M. Okarvi Abstract An Erratum has been published for this article in Medicinal Research Reviews 2004;24:685,686. Small synthetic receptor-binding peptides are the agents of choice for diagnostic imaging and radiotherapy of cancers due to their favorable pharmacokinetics. Molecular modification techniques permit the synthesis of a variety of bioactive peptides with chelating groups, without compromising biological properties. Various techniques have been developed that allow efficient and site-specific labeling of peptides with clinically useful radionuclides such as 99mTc, 123I, 111In, and 18F. Among them, 99mTc is the radionuclide of choice because of its excellent chemical and imaging characteristics. Recently, many 99mTc-labeled peptides have proven to be useful imaging agents. Beside 99mTc-labeled peptides, several peptides radiolabeled with 111In and 123I have been prepared and characterized. In addition, 18F-labeled peptides hold clinical potential due to their ability to quantitatively detect and characterize a variety of human diseases using positron-emission tomography. The availability of this wide range of peptides labeled with different radionuclides offers multiple diagnostic and therapeutic applications. Various receptors are over-expressed in particular tumor types and peptides binding to these receptors can be used to visualize tumor lesions scintigraphically. Thus, radiolabeled peptides have potential use as carriers for the delivery of radionuclides to tumors, infarcts, and infected tissues for diagnostic imaging and radiotherapy. Many radiolabeled peptides are currently under investigation to determine their potential as imaging agents. These peptides are designed mainly for thrombus, tumor, and infection/inflammation imaging. This article presents recent developments in small synthetic peptides for imaging of thrombosis, tumors, and infection/inflammation. © 2004 Wiley Periodicals, Inc. Med Res Rev, 24, No. 3, 357,397, 2004 [source] Scope of practice, referral patterns and lesion occurrence of an oral medicine service in AustraliaORAL DISEASES, Issue 4 2008CS Farah Aim:, The purpose of this study was to examine the scope of practice, lesion occurrence and utilisation of referral-based hospital and private practice oral medicine and oral pathology (OMP) services in Australia. Materials and methods:, Clinical records of patients referred to a hospital (n=500) and private (nbequals;1104) OMP clinic were audited. For each patient, the following parameters were recorded: age, gender, source of referral, reason for referral, site of lesion/condition if applicable, medical and drug history, diagnostic services utilised, clinical and histopathological diagnoses rendered, medications prescribed and further treatment required. Results:, A majority of the referrals were generated by general dental practitioners. The most commonly seen problems were epithelial hyperplasia/hyperkeratosis, oral candidosis, oral lichen planus, xerostomia, recurrent aphthous ulcers and burning mouth syndrome. OMP specialists requested diagnostic imaging for 13% of hospital and 9.42% of private patients, diagnostic biopsies were required for 18.4% of hospital and 19.3% of private patients, blood tests were ordered for 14.4% of hospital and 12.13% of private patients, while medications were prescribed for approximately 36% of hospital and 51% of private patients. Conclusions:, This study is the first to detail the scope of practice, lesion occurrence and utilisation of services offered by OMP specialists in Australia. The demand for OMP services is strong. [source] The use of remifentanil for inducing apnea during diagnostic imaging in sedated pediatric patientsPEDIATRIC ANESTHESIA, Issue 12 2008Martin Jöhr No abstract is available for this article. [source] Pentobarbital vs chloral hydrate for sedation of children undergoing MRI: efficacy and recovery characteristicsPEDIATRIC ANESTHESIA, Issue 7 2004Shobha Malviya MD Summary Background :,Chloral hydrate (CH) sedation for magnetic resonance imaging (MRI) is associated with significant failure rates, adverse events and delayed recovery. Pentobarbital (PB), reportedly produces successful sedation in 98% of children undergoing diagnostic imaging. This study compared the efficacy, adverse events and recovery characteristics of CH vs PB in children undergoing MRI. Methods :,With Institutional Review Board approval and written consent, children were randomly assigned to receive intravenous (i.v.) PB (maximum 5 mg·kg,1 in incremental doses) or oral CH (75 mg·kg,1) prior to MRI. Sedation was augmented with 0.05 mg·kg,1 doses of i.v. midazolam (maximum 0.1 mg·kg,1) as necessary. Adverse effects, including hypoxaemia, failed sedation, paradoxical reactions and behavioural changes, the return of baseline activity, and parental satisfaction were documented. The quality of MRI scans was evaluated by a radiologist blinded to the sedation technique. Results :,PB facilitated an earlier onset of sedation (P = 0.001), higher sedation scores (P = 0.01), and less need for supplemental midazolam compared with CH. Severe hypoxaemia occurred in two children (6%) in the PB group. Fourteen per cent of the PB group experienced a paradoxical reaction, 9% sedation failure and 11% major motion artefact, compared with 0% (P = 0.05), 3 and 2% (P = NS), respectively, in the CH group. CH and PB were both associated with a high incidence of motor imbalance, and agitation. However, children who received PB had a slower return to baseline activity (P = 0.04). Conclusions :,Although PB facilitated a quicker sedation onset and reduced the requirement for supplemental sedation, it produced a higher incidence of paradoxical reaction and prolonged recovery with a similar failure rate compared with CH. [source] Fibromatosis of the Breast: Case Report and Current Concepts in the Management of an Uncommon LesionTHE BREAST JOURNAL, Issue 1 2006Graham S. Schwarz MD Abstract: Fibromatosis is an uncommon breast lesion that can mimic breast carcinoma in its clinical presentation. We present a case in which excisional biopsy was necessary to establish a diagnosis of fibromatosis. Clinical, diagnostic imaging, and pathologic features are discussed. Magnetic resonance imaging (MRI) has emerged as a tool for further characterization of breast lesions and as a screening modality in high-risk patient populations. Ours marks the second case in which dynamic MRI has been correlated with histologically confirmed primary mammary fibromatosis. Unlike the previous report, MRI in this case mimics breast carcinoma in its morphologic and pharmacokinetic features of enhancement. Wide local excision with clear margins remains the treatment of choice. Current data on radiotherapy and pharmacologic therapy for mammary fibromatosis are reviewed., [source] Virtobot,a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsyTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 1 2010Lars Christian Ebert Abstract Background The Virtopsy project, a multi-disciplinary project that involves forensic science, diagnostic imaging, computer science, automation technology, telematics and biomechanics, aims to develop new techniques to improve the outcome of forensic investigations. This paper presents a new approach in the field of minimally invasive virtual autopsy for a versatile robotic system that is able to perform three-dimensional (3D) surface scans as well as post mortem image-guided soft tissue biopsies. Methods The system consists of an industrial six-axis robot with additional extensions (i.e. a linear axis to increase working space, a tool-changing system and a dedicated safety system), a multi-slice CT scanner with equipment for angiography, a digital photogrammetry and 3D optical surface-scanning system, a 3D tracking system, and a biopsy end effector for automatic needle placement. A wax phantom was developed for biopsy accuracy tests. Results Surface scanning times were significantly reduced (scanning times cut in half, calibration three times faster). The biopsy module worked with an accuracy of 3.2 mm. Discussion Using the Virtobot, the surface-scanning procedure could be standardized and accelerated. The biopsy module is accurate enough for use in biopsies in a forensic setting. Conclusion The Virtobot can be utilized for several independent tasks in the field of forensic medicine, and is sufficiently versatile to be adapted to different tasks in the future. Copyright © 2009 John Wiley & Sons, Ltd. [source] Evolution in the Assessment and Management of Trigeminal SchwannomaTHE LARYNGOSCOPE, Issue 2 2008Bharat Guthikonda MD Abstract Educational Objective: At the conclusion of this presentation, the participants should be able to understand the contemporary assessment and management algorithm used in the evaluation and care of patients with trigeminal schwannomas. Objectives: 1) Describe the contemporary neuroradiographic studies for the assessment of trigeminal schwannoma; 2) review the complex skull base osteology involved with these lesions; and 3) describe a contemporary management algorithm. Study Design: Retrospective review of 23 cases. Methods: Chart review. Results: From 1984 to 2006, of 23 patients with trigeminal schwannoma (10 males and 13 females, ages 14,77 years), 15 patients underwent combined transpetrosal extirpation, 5 patients underwent stereotactic radiation, and 3 were followed without intervention. Of the 15 who underwent surgery, total tumor removal was achieved in 9 patients. Cytoreductive surgery was performed in six patients; of these, four received postoperative radiation. One patient who underwent primary radiation therapy required subsequent surgery. There were no deaths in this series. Cranial neuropathies were present in 14 patients pretreatment and observed in 17 patients posttreatment. Major complications included meningitis (1), cerebrospinal fluid leakage (2), major venous occlusion (1), and temporal lobe infarction (1). Conclusions: Trigeminal schwannomas are uncommon lesions of the skull base that may occur in the middle fossa, posterior fossa, or both. Moreover, caudal extension results in their presentation in the infratemporal fossa. Contemporary diagnostic imaging, coupled with selective use of both surgery and radiation will limit mor-bidity and allow for the safe and prudent management of this uncommon lesion. [source] A new generation of monoclonal and recombinant antibodies against cell-adherent prostate specific membrane antigen for diagnostic and therapeutic targeting of prostate cancerTHE PROSTATE, Issue 13 2006Ursula Elsässer-Beile Abstract BACKGROUND Prostate-specific membrane antigen (PSMA) is an excellent candidate for targeting prostate cancer by virtue of its restricted expression on prostatic epithelial cells and its upregulation on prostatic carcinoma cells. PSMA is expressed on the cell surface displaying a specific three-dimensional structure. Therefore, only antibodies with a high cell binding activity will have an important impact on antibody-based imaging and therapy. METHODS Monoclonal antibodies (mAbs) and single chain antibody fragments (scFvs) were prepared from spleen cells of mice that had been immunized either with purified PSMA or a cell lysate of prostate cancer LNCaP cells containing native PSMA. mAbs and scFvs were screened for reactivity with purified PSMA and binding to PSMA-expressing LNCaP cells. RESULTS From mice immunized with purified PSMA, we obtained three mAbs (K7, K12, D20) and four scFvs (G0, G1, G2, G4), which were highly reactive with the isolated antigen, but showed weak or no reaction with viable LNCaP cells. From mice immunized with unpurified LNCaP lysate, we obtained three mAbs (3/E7, 3/F11, 3/A12), and one scFv (A5), which were reactive with purified PSMA, also showing a strong and specific binding to viable LNCaP cells and PSMA-transfected cells. CONCLUSIONS Our results suggest that only the mAbs and scFvs, that were elicited with unpurified LNCaP lysate and not with purified PSMA will be useful agents for diagnostic imaging and therapeutic applications of prostate cancer. Prostate 66: 1359,1370, 2006. © 2006 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||